OBJECTIVE:High-intensity interval training(HIIT)and moderate-intensity continuous training(MICT)can improve the quality of life of patients with clinical chronic diseases,but their application effects and regulatory factors in adults with insufficient physical activity are still unclear.This study aimed to explore the application effects and regulatory factors of HIIT and MICT on the quality of life of adults with insufficient physical activity. METHODS:A systematic literature search was conducted in databases including Web of Science Core Collection,Medline(EBSCO Host),PubMed,and Cochrane Library.The search time limit was from the establishment of each database to September 2023.The types of included literature were randomized controlled trials,and the research subjects were physically inactive adults.RevMan 5.4 software and the GRADE evidence evaluation framework were used to assess the quality of the included literature.Main effects pooling of random effects models was performed using R Studio(version 4.2.0).Subgroup analyses,regression analyses,and sensitivity analyzes were used to explore the sources of study heterogeneity and moderators. RESULTS:(1)Thirty-two randomized controlled trials of moderate to high quality were included,involving 2 083 physically inactive adults(HIIT group n=474;MICT group n=708;control group n=901).(2)Compared with the non-training control group,HIIT[Hedges'g=0.61;95%confidence interval(CI):0.40-0.83;I2=45%]and MICT(Hedges'g=0.66;95%CI:0.25-1.08;I2=89%)significantly improved the quality of life.Direct comparison studies of HIIT and MICT found no significant differences in the quality of life(Hedges'g=-0.01;95%CI:-0.23-0.21;I2=0%).(3)Subgroup analysis showed that HIIT and MICT were more effective in improving the physical components of the quality of life(HIIT:Hedges'g=0.82 vs.0.75;MICT:Hedges'g=0.74 vs.0.55),while cycling had a better trend in improving overall quality of life(HIIT:Hedges'g=0.74 vs.0.36;MICT:Hedges'g=1.08 vs.0.52).(4)Additionally,regression analysis did not identify any significant moderators(P>0.05 for all factors).(5)None of the above meta-analyses found publication bias(Egger test P>0.05). CONCLUSION:(1)Moderate to high level evidence shows that both HIIT and MICT can improve the quality of life of adults with insufficient physical activity,and the intervention effects between the two are similar.Therefore,when choosing between these two options,it is necessary to comprehensively consider factors such as time economy,scheduling flexibility,and application feasibility to formulate a personalized exercise plan.(2)This study recommends that when applying HIIT,a low-volume protocol(for example,5 groups each time,1 minute each),3 times/week,and ride at 80%-95%of the maximum heart rate is used to achieve the theoretical best improvement effect.(3)Although MICT improves the quality of life,there is insufficient evidence that increasing exercise duration brings additional benefits.Therefore,this study recommends that when MICT is conducted,it should be carried out more than three times a week,with each training duration controlled between 25 and 60 minutes,and cycling at 50%-75%of the maximum heart rate,in order to achieve the theoretically expected best improvement effect.

Hemiplegic migraine （HM） is a specific subtype of migraine with aura and is difficult to diagnose due to its low incidence rate and diverse clinical symptoms. This article reports a case of HM with hemiplegia as the initial presentation. This patient had a long course of disease and critical conditions and was comorbid with intractable epileptic seizures. A literature review is performed to improve the understanding of this disease among clinicians.
Stroke

In recent years, the role of omega-3 polyunsaturated fatty acids (n-3 PUFAs) in the prevention and treatment of ischemic stroke has received widespread attention. Researches have shown that n-3 PUFAs can reduce the risk of stroke and improve stroke outcome through various mechanisms, including anti-inflammatory, antioxidant, improvement of endothelial function, promotion of angiogenesis, and anti-apoptotic effects, demonstrating potential in the prevention and treatment of ischemic stroke. This article reviews the mechanism of action and clinical research of n-3 PUFAs in ischemic stroke.

Symptomatic intracranial atherosclerotic stenosis (sICAS) is an important cause of ischemic stroke, and its hemodynamic changes play an important role in the pathogenesis of stroke. Computational fluid dynamics (CFD), as a powerful numerical simulation tool, can accurately simulate and evaluate the hemodynamic state within blood vessels, providing a new perspective for a deeper understanding of the hemodynamic mechanism and clinical significance of sICAS. This article reviews the application of CFD in evaluating the stroke mechanism and secondary prevention of stroke in patients with sICSA.

The elderly are prone to develop severe disease or die after infection with SARS-CoV-2, and inoculation of COVID-19 vaccine is of great significance to reduce the serious case and death. Several COVID-19 vaccines have been administered and demonstrated their safety and effectiveness in the real world. This review summarizes the safety and effectiveness of COVID-19 vaccines in the real-world studies, especially the rare adverse reactions associated with vaccine and protection against severe disease, hospitalization and death in different epidemiological contexts.

Objective:To develop a nomogram model for predicting short-term poor outcome after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS) based on imaging markers of cerebral small vessel disease (CSVD).Methods:Patients with AIS received intravenous thrombolysis treatment at Jining No. 1 People's Hospital from January 2021 to December 2023 were retrospectively included. MRI was used to evaluate imaging markers of CSVD, including lacunar infarction (LI), cerebral microbleeds (CMBs), white matter hyperintensities (WMHs), and enlarged perivascular spaces (EPVS). The outcome evaluation was performed at 90 days after onset using the modified Rankin Scale, and the score of >2 was defined as poor outcome. LASSO regression analysis was used to screen the variables most correlated with poor outcome after intravenous thrombolysis, and construct a nomogram for predicting poor outcome through a logistic regression model. The predictive ability of the nomogram was verified through the receiver operating characteristic curve, calibration chart, and decision curve analysis. Results:A total of 167 patients were included, of which 96 (57%) had good outcome and 71 (43%) had poor outcome. The variables with P<0.05 in univariate analysis were included in the LASSO regression model to screen for variables. Finally, left side infarction, atrial fibrillation, baseline systolic blood pressure, baseline National Institutes of Health Stroke Scale (NIHSS) score, high-density lipoprotein cholesterol, WMHs (1 point), CMBs (1 point), EPVS (1 point), LI (1 point), and overall CSVD load (2-4 points) were included in the multivariate logistic regression analysis. The results showed that atrial fibrillation (odds ratio [ OR] 6.75, 95% confidence interval [ CI] 1.49-41.40; P=0.022), baseline systolic blood pressure ( OR 1.01, 95% CI 1.00-1.04; P=0.049), baseline NIHSS score ( OR 1.47, 95% CI 1.23-1.80; P<0.001), WMHs ( OR 3.40, 95% CI 1.28-9.53; P=0.015), CMBs ( OR 3.24, 95% CI 1.12-9.90; P=0.032) and EPVS ( OR 2.89, 95% CI 1.05-8.23; P=0.041) were the independent risk factors for poor outcome. The nomogram model was developed using these variables. The receiver operating characteristic curve analysis showed that the area under the curve was 0.885 (95% CI 0.837-0.933; P<0.01), indicating that the model had good discrimination. The consistency between the predicted and actual values of the nomogram model was good. Conclusion:The nomogram model for predicting the probability of poor outcome developed from atrial fibrillation, baseline systolic blood pressure, baseline NIHSS score, WMHs, CMBs, and EPVS has good discrimination and calibration, and has certain clinical practicality.

Objective:To investigate risk factors for in-stent restenosis (ISR) after percutaneous transluminal angioplasty and stenting (PTAS) in patients with severe symptomatic intracranial carotid stenosis.Methods:Consecutive patients with severe symptomatic intracranial carotid stenosis underwent PTAS in the Department of Neurology, Jining First People's Hospital from December 2021 to June 2023 were retrospectively included. Clinical and procedure related data were collected, and periprocedural complications were recorded. Imaging follow-up was used to evaluate ISR after 6 months. Multivariate logistic regression analysis was used to determine independent risk factors for ISR. Results:A total of 73 patients were enroled, including 45 males (61.6%), aged 61.49±7.78 years. The median follow-up time was 8 months (interquartile range, 7-9 months; range, 6-10 months), with 19 cases (26.0%) experiencing ISR, of which 1 (1.4%) had symptomatic ISR. Multivariate logistic regression analysis showed that the higher degree of residual stenosis immediately after procedure (odds ratio [ OR] 1.102, 95% confidence interval [ CI] 1.004-1.209; P=0.040), accompanied by moderate to severe cerebrovascular stenosis in other areas ( OR 6.638, 95% CI 1.106-39.835; P=0.038) and low preprocedural white blood cell count ( OR 0.541, 95% CI 0.308-0.952; P=0.033) were the independent risk factors for ISR. Conclusion:The higher degree of residual stenosis immediately after procedure, accompanied by moderate to severe cerebrovascular stenosis in other areas, and lower preprocedural white blood cell count are the risk factors for the occurrence of ISR after PTAS in patients with severe intracranial carotid stenosis.

Intracranial atherosclerotic stenosis (ICAS) is closely associated with cognitive impairment and dementia. This article reviews the manifestations, mechanisms, and interventions of cognitive impairment in patients with ICAS, aiming at increasing attention to ICAS, early identification and intervention, and delaying the occurrence and deterioration of cognitive impairment.

Intracranial atherosclerotic stenosis (ICAS) is one of the most common causes of ischemic stroke worldwide. A variety of factors are associated with the occurrence and development of ICAS, including gender, age, persistent inflammatory state, hypertension, hyperlipidemia and diabetes. Early identification and appropriate management of risk factors for ICAS are of great significance for actively preventing and treating ICAS and reducing the risk of ischemic stroke occurrence and recurrence.

Intracranial atherosclerotic stenosis (ICAS) is the main cause of ischemic stroke. Endovascular therapy (EVT) is a method of treating symptomatic ICAS, and in-stent restenosis (ISR) is an important factor affecting the efficacy of EVT. This article summarizes the influencing factors of ISR in patients with ICAS receiving EVT treatment.